NOTE: THIS POSITION HAS THE ABILITY TO WORK REMOTELY UNTIL FURTHER NOTICE

At Innovista, we believe that primary care is uniquely positioned to drive transformational change in healthcare. Our independent physician partners achieve clinical and operational excellence in every spectrum of value-based care, resulting in better patient care and positive outcomes for their practices. Innovista Health is a full-service management services organization that offers solutions for practice transformation, including multi-payer program administration, quality, utilization, and care coordination services, and performance improvement insights and reporting.

Innovista Health Solutions is an Illinois-based service organization with management services operations in Illinois and Texas. At Innovista, we believe that positive forward movement in today’s uncertain healthcare market stems from the combination of innovative programs and dedicated people. Join the Innovista team and lead the charge to a better, more efficient healthcare system.

JOB SUMMARY:

Responsible for acting as a liaison between members, health providers and Health Plans. Assists in the resolution of calls: claims questions, billing, complaints, and other queries.

DUTIES AND RESPONSIBILITIES

• Responsible for responding to and timely resolution of all incoming calls on designated customer services’ telephone lines. These phone calls will include but are not limited to the following:
• Member Calls:
• Resolve claim issues
• Assist in resolution of difficulties with access and telephone availability of physician offices
• Determine eligibility
• Health Plan Calls:
• Eligibility and claim inquiries
• Assist in resolution of member complaints
• Provider Office Calls:
• Respond to claim inquiries
• Verify eligibility and co-payments
• Maintain documentation of types and number of phone calls
• Process member and provider correspondence
• Process incoming faxes received
• Maintains all necessary levels of member/patient privacy in accordance with HIPAA standards.
• Perform other duties as assigned

• Associate degree or equivalent experience required
• At least 2-3 years of relevant professional experience, including customer service environment.
• Knowledge of CPT 4, HCPCS and ICD-10 coding and medical terminology.
• Bilingual is a plus
• Excellent organizational skills.
• Demonstrate effective verbal and written communication skills.
• Demonstrate analytic skills when problem solving.
• Proficient in MS Office Applications and ability to learn department and job specific software systems.
• Demonstrate high attention to detail and a high degree of accuracy
• Able to commit to Innovista’s corporate mission and values
• Able to switch priorities in a positive and effective manner when directed by Company leadership.
• Able to effectively communicate technical concepts with team members and basic business concepts with team members and internal customers.

BENEFITS:

• Innovista is dedicated to hiring passionate individuals who embody our core values: integrity, determination, and teamwork. We recognize the importance of work-life integration and seek to provide our employees with competitive benefits, which include:
• Competitive benefits package including subsidized medical insurance with Flexible Spending Account (FSA), Health Savings Account (HSA) and Health Reimbursement Account (HRA) options as well as dental and vision coverage
• Company-paid benefits, such as short- and long-term disability, employee life, and Accidental Death and Dismemberment (AD&D)
• Annual discretionary bonus
• Generous paid time off that increases with tenure
• Paid company holidays (9 per year)
• Paid Parental Leave
• Employee Assistance Program available
• 401(k) with Company Match
• Potential to work remotely or hybrid
• Flexible work hours may be available
• Continuous education opportunities
• Dress for your day policy
• Discounted gym membership program through medical coverage
• Opportunity for career advancement and growth
• Generous employee referral bonuses
• Open-door policy with our CEO and upper management
• Please note: We do not post salary ranges. Salary ranges posted on other sites are not tied to our labor market specifications and are not relevant.